Epiretinal membrane surgery with or without internal limiting membrane peeling

Abstract

Background: The purpose of the present paper was to evaluate the visual outcome and recurrence rate of epiretinal membrane (ERM) formation following vitreoretinal surgery with and without internal limiting membrane (ILM) peel.

Methods: The medical records of 42 consecutive patients who underwent surgery for macular ERM by a single surgeon were reviewed. All patients underwent pars plana vitrectomy and ERM removal with a subset undergoing ILM peel. Recurrence of macular ERM within 18 months and the final visual outcome after surgery were compared between patients with and without ILM removal.

Results: Twenty-five patients (59.5%) underwent ERM surgery with ILM peeling and 17 patients (40.5%) underwent ERM surgery without ILM peeling. The mean preoperative logMAR visual acuity was 0.77 and 0.96 for the ILM peeling and non-ILM peeling groups, respectively. Visual acuity improved significantly in both the ILM and non-ILM peeling groups after ERM surgery (P < 0.001 and P = 0.003, respectively). Eighteen months after surgery, 3/17 eyes without ILM peeling (17.6%) developed recurrent macular ERM, compared with none of the 25 eyes with ILM peeling (log-rank test, P = 0.030).

Conclusions: Internal limiting membrane removal during macular ERM surgery may minimize the recurrence of ERM, without adverse visual outcome. Further controlled prospective studies are needed to determine the role of ILM peeling in ERM surgery.